Planning is central to the success of the NDIS, with a plan determining whether a participant can achieve their goals, access therapeutic supports and achieve quality of life. As one participant submitted:
I want the Committee to get an understanding into how unimaginably stressful planning is – the stakes are too high. Planning determines so many things about my life and the NDIS has absolute control. This can never not be terrifying for anybody who is severely disabled.
If anything goes really wrong… my worst nightmare is that I lose my remaining independence and in the worst case would have to move into a hospital or aged care facility…
However, planning, when it works well, changes lives for the better. As one participant reported to People with Disabilities (WA), NDIS funding for supports 'has greatly increased my quality of life. I went from being a home bound person to having a big social and recreational calendar'.
For years, participants, advocacy groups and the sector have been calling for reform in the planning arena. This inquiry, including the committee's interim report tabled in December 2019, and the Review of the NDIS Act and the new NDIS Participant Service Guarantee (Tune Review) make broad-ranging recommendations to address long-standing issues with the planning process.
The committee was informed that there may be major inconsistencies in plan funding between participants with the same disability type and even, in some instances, between siblings with the same disability type. Some plans are not including funded supports with the reason that a participant has informal supports, including family members, who can provide these supports instead—despite the participant having no informal supports, or having elderly parents with dementia who are no longer able to take a caregiving role. A further example of the reasons the National Disability Insurance Agency (NDIA) provided for refusing to fund particular supports included that these supports should be available in another service system, such as health, without determining first that these supports are in fact available and the participant is eligible for them. Such decisions, the committee learned, can have significant consequences for participants, and may be a matter of life and death.
Evidence also indicated that planner errors, such as listing the wrong disability in participants' plans, were a result of high workloads. Planners, the committee heard, were sometimes unaware of participants' disabilities and were relying on internet search engines for their information. In addition, planners may be ignoring or changing expert recommendations provided by allied health practitioners about the supports that are appropriate for a particular participant.
Where participants are unhappy with an NDIA decision, and the NDIA's internal review process upholds this decision, they are able to appeal the decision to the Administrative Appeals Tribunal (AAT). However, the committee was informed that there are major concerns with the NDIA's response to AAT applications, including the NDIA using private lawyers to argue cases while participants may be unable to afford similar representation, and the lack of transparency around cases that are settled in the conciliation process. An issue the committee was especially concerned about was that some plans the NDIA has offered to participants after an order by the AAT may not reflect the order or, after the plan has ended, the supports that the AAT ordered have not been included in the new plan.
Evidence also suggested that problems remain with the NDIA's communication processes, with planners sometimes replying to queries from participants and their nominees months later, or not replying at all. Participants, in some instances, have not been invited to planning meetings, or been spoken to appropriately during planning meetings. The NDIA often points to its participant satisfaction ratings as proof that participants and their nominees are happy with the NDIA's performance but these may not be an accurate reflection of actual satisfaction with the planning process because of their wording.
Many issues identified in this report have arisen because many participants never meet with the NDIA delegate who makes decisions about the content and funding of their plans. The Australian Government in March 2020 began the national roll-out of joint planning meetings, which involve the participant meeting with the NDIA delegate and, if relevant, their Local Area Coordinator or Early Childhood Early Intervention partner, and seeing a draft plan. The roll-out of joint planning has been paused because of the COVID-19 pandemic.
The committee made 14 recommendations in its interim report and it makes another 42 recommendations in this final report. These recommendations are intended to bring greater transparency, consistency and accountability to how the NDIS is administered and implemented.
Finally, as noted throughout this report, a number of the issues raised in evidence to the inquiry have been the subject of recent government announcements, such as joint planning, improved transparency and a commitment to clear timeframes for decisions. This does not mean that these issues are resolved, merely that the NDIA and the Australian Government have recognised the need to address them. The committee welcomes these efforts, and urges the government to continue to improve the planning process. The committee will continue to observe reforms and changes in the planning arena and make recommendations in future inquiries if it considers that this is needed.
The committee thanks all those who contributed to the inquiry, particularly participants, their family members and advocates who gave the inquiry first-hand information about their experiences with the NDIS planning process.